At least five of 50 Vietnam War combat veterans who participated in a Veterans Affairs study have tested positive for a waterborne parasite that’s rare beyond Asia, hides unseen in the body for decades and can cause a deadly form of liver cancer, according to interviews and documentation provided by participants in the study.
The survey was conducted last spring at the VA Medical Center at Northport.
Four of the survey participants — the fifth has since died — said they know of nine others who have tested positive for the parasite. If confirmed, that would bring to 14, or more than one in four, the number of study participants shown to have harbored the parasite, known as liver fluke.
The four men, who each shared with Newsday a VA letter confirming their positive result, say they want Northport to release the survey immediately and to encourage all who served in Vietnam to be tested as a precaution.
The fifth Vietnam veteran known to have tested positive, Jim Delgiorno, died Oct. 3 of cholangiocarcinoma, a rare cancer associated with the parasite, according to his wife, Elizabeth. And Gerald “Jerry” Chiano, a Valley Stream Vietnam vet who was not part of the study because he was already known to have harbored liver fluke, died Sunday of the same disease.
“We thought that by taking the test, we would be raising awareness and saving the lives of others,” said Port Jefferson Station resident Gerald Wiggins, 69, who served in Vietnam in 1968 and 1969, and who tested positive for one species of the fluke. “We never thought we would be fighting for our own lives.”
A spokesman for Northport said the VA has not urged all Vietnam veterans to be tested because “no definitive link has been made between the parasite and liver cancer.” He said the study’s results will not be released until they have been peer-reviewed and published by a medical journal.
“VA is not taking this lightly, but until further research, a recommendation cannot be made either way,” Northport spokesman Todd Goodman said in an email.
Northport’s liver fluke study was conducted between April and June by the agency’s chief of infectious diseases, Dr. George Psevdos, who took blood samples that were sent to Seoul National University in South Korea. According to The Associated Press, Sung-Tae Hong, the Seoul parasitologist who evaluated the samples, said he found evidence of liver fluke in more than 20 percent of them.
Some activists have likened the seriousness of fluke exposure in Vietnam veterans to Agent Orange, a class of dioxin-contaminated herbicides believed to have tainted hundreds of thousands of U.S. troops. The VA pays disability claims to Vietnam veterans who were exposed to the more than 10 million gallons of the defoliant sprayed in Vietnam during the war, and who suffer from any of a host of maladies linked to exposure, from heart disease to bladder cancer.
Since 2013, the VA has received 240 disability claims related to “cholangio or intrahepatic conditions” — bile-duct cancers and other maladies associated with liver-fluke, the agency said. It had rejected more than 76 percent of those claims.
According to the Centers for Disease Control, untreated liver fluke infestations are a serious menace that “can lead to cancer, which can be fatal.” Varieties of liver fluke that infest human hosts are endemic in Southeast Asia, the Korean Peninsula, China and parts of Siberia, and relatively rare in most other parts of the world.
The parasite spends part of its life cycle growing in a variety of freshwater snails. The snails release a virulent form of the fluke, which can be passed into humans through contaminated drinking water or undercooked fish.
The parasite can survive for decades without detection. Infestations can be readily eliminated with oral doses of praziquantel and/or triclabendazole, according to the World Health Organization.
Two months before Delgiorno died, he told Newsday he had been stationed near the Laotian border with the 101st Airborne Division, from 1968 to 1969.
“We all drank the water from the rivers,” he told Newsday in July. “It was hot, and you drank water where you could find it.”
Delgiorno’s wife Elizabeth said he had been diagnosed with cholangiocarcinoma.
“The tumors just took over,” she said.
The other four men interviewed by Newsday were informed of the results over the summer in letters signed by Psevdos.
“The result was positive for exposure to the C.sinesis parasite,” Wiggins’ letter read.
Liver flukes, which can grow to about an inch and a half long, burrow through the walls of the small intestine before migrating to the bile ducts and causing damage there.
Varieties of the worm infect an estimated 35 million people worldwide, according to an article published by the National Institutes of Health. The vast majority live in China and Southeast Asia, where more than one in three residents of heavily infested areas may harbor the parasite. That ratio in Vietnam is about one in seven, according to the World Health Organization.
Varieties of liver flukes can found in cattle and sheep that graze in wetlands in some parts of the United States, according to the U.S. Department of Agriculture. But the rarity of human-borne liver fluke in the United States — health experts say Americans with the parasite are almost always found to have been infected overseas — has led to delayed diagnosis and mismanagement of related diseases.
John Butzgy, 65, a former Army truck driver from Seaford who served in Vietnam in 1972, said he has wanted to be evaluated since reading about the parasite in a July Newsday article. He wonders if his medical problems — he said he frequently vomits bile and has been diagnosed with a fatty liver — are related.
“I just want to be tested before I die,” Butzgy said. “I don’t want to be on the obituary page next year.”